Indications for Small-bowel Capsule Endoscopy in Patients with Chronic Abdominal Pain

• Published in: Internal Medicine Vol. 56; no. 12; pp. 1453 - 1457
• Main Authors: Ueno, Yoshitaka, Igawa, Atushi, Kunihara, Sayoko, Tanaka, Shinji, Oka, Shiro, Ito, Masanori, Chayama, Kazuaki, Nakano, Makoto
• Format: Journal Article
• Language: English
• Published: Japan The Japanese Society of Internal Medicine 01.01.2017; Japan Science and Technology Agency
• Subjects: Abdomen; Abdominal Pain - diagnostic imaging; Abdominal Pain - epidemiology; Abdominal Pain - pathology; Adult; Aged; C-reactive protein; C-Reactive Protein - analysis; capsule endoscopy; Capsule Endoscopy - methods; chronic abdominal pain; Chronic pain; Colon; Endoscopy; Female; Humans; Internal medicine; Intestine, Small - diagnostic imaging; Intestine, Small - pathology; Irritable bowel syndrome; Irritable Bowel Syndrome - epidemiology; Irritable Bowel Syndrome - pathology; Male; Middle Aged; Original; Small intestine; small-bowel; small-bowel; chronic abdominal pain; irritable bowel syndrome; capsule endoscopy
• ISSN: 0918-2918; 1349-7235; 1349-7235
• DOI: 10.2169/internalmedicine.56.7458

Objective The aim of the present study is to assess the difference in the detection rates of small-bowel lesions in chronic abdominal pain (CAP) patients with irritable bowel syndrome (IBS) and non-IBS. Patients Ninety-nine CAP patients who were scheduled to undergo capsule endoscopy (CE) to investigate their abdominal symptoms were included in this study. Among the subjects, 34 patients fulfilled the Rome III criteria for IBS (IBS group); the remaining 65 patients were categorized as the non-IBS group. CE was performed in both groups and the total enteroscopy achievement rate, small-bowel lesion detection rate, and the presence of small-bowel lesions were evaluated. We also evaluated the patients' blood test results and the rate at which abdominal symptoms improved following internal medication. Results Total enteroscopy was achieved in 62% (21/34) and 86% (56/65) of the IBS and non-IBS patients, respectively. The total enteroscopy achievement rate was significantly higher in non-IBS patients. The small-bowel lesion detection rates were 3% (1/34) and 19% (12/65), respectively, and the detection rate was significantly higher in the non-IBS patients. In the non-IBS patients, mean C-reactive protein (CRP) was significantly higher in the patients with small-bowel lesions. The abdominal symptoms of 12 (92%) of the CAP patients with small-bowel lesions were improved by internal medication. Conclusion CE may be considered for non-IBS CAP patients with high levels of CRP.